Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XS0106X | Orthopaedic Hand Surgeon | 36565 | CO |
Y | 207XS0106X | Orthopaedic Hand Surgeon | A106196 | CA |
NPI | 1043287618 |
---|---|
Provider Name | Dr. Christopher Jerome Wilson |
First Address | Sacramento, CA 95816-5243 |
Second Address | Sacramento, CA 95816-5243 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2006 |
Last Update Date | 06/08/2010 |